No / While awareness among people with mild to moderate dementia residing in the community has been extensively studied, little evidence has been presented regarding the extent to which people with moderate to severe dementia living in residential care show awareness of their own situation and functioning. The present study aimed to explore how differing degrees of awareness are manifested in the conversations and interactions of people with dementia living in residential care settings, and to identify theoretical and practical implications. Transcripts of 304 conversations with 80 individuals with dementia living in residential care homes in England and Wales were analysed using a grounded theory approach. All 80 participants demonstrated a degree of retained awareness, and there was considerable evidence of retained awareness throughout the conversations, expressed in relation to the three domains of self, relationship, and the environmental context. Two-thirds of participants also demonstrated at least one instance of unawareness, although demonstrations of retained awareness outweighed indications of unawareness. Unawareness was evident in relation to appraisal of functioning and the meaning ascribed to the situation. A grounded theory model of awareness in people with moderate to severe dementia who still communicate verbally proposes that demonstration of awareness involves a set of analytic and behavioural processes, a scope or timescale, and a focus. Awareness is demonstrated in relation to a given focus and scope through the involvement of cognitive processes of varying degrees of complexity, ranging from registering through appraising and interpreting to reflection. Unawareness may be demonstrated in relation to some elements of process, focus or scope, while other aspects remain unaffected. Understanding more about the capacity for retained awareness and the specific ways in which awareness can be compromised may assist care staff in responding effectively to residents' needs.

Counselors and other mental health professionals lack training on healthy sexuality and sexual identity development (SID). To begin to construct a comprehensive model of SID that can be used in counseling and counselor education, I conducted an exploratory study utilizing a grounded theory approach to collect and analyze SID stories from a purposive sample of eight adults from the Dallas-Fort Worth, Texas area: four male and four female; seven White Caucasian-American and one Asian American; and self-identified as two gay, one lesbian, three heterosexual, and two sexually fluid. Participants elucidated a process model of the sexual-self that incorporated biological, psychological, social, cultural, and spiritual factors. Emergent themes included discovering, distinguishing, placing boundaries around, differentiating, and integrating the sexual-self. This preliminary model advanced a more holistic understanding of SID that counselors and other mental health professionals, educators, and researchers may find useful within their respective disciplines.

Background: AI in Purchasing and Supply Management (PSM) enhances business operations but faces challenges in adoption due to limited research and AI readiness assessment. Although existing research explores AI's potential, the issue of assessing and achieving AI readiness in PSM remains underexamined. Exploring this gap is crucial to understanding how AI can effectively transform procurement processes and improve strategic operations.  Purpose: This study aims to identify and evaluate the essential capabilities that PSM organizations need to develop for AI readiness, using a dynamic capabilities framework to provide insights for both academia and practitioners.  Method: Grounded theory is applied for its flexibility and constructivist principles, allowing theories to emerge from the data collected through semi- structured interviews, providing a comprehensive understanding of AI readiness in PSM. The primary data consisted of 13 interviews with AI users, implementers, and developers.  Conclusion: Identified capabilities needed for successful AI implementation in PSM, include robust technological infrastructure, effective AI governance, and the importance of communication and continuous learning. The study concludes that AI readiness in PSM requires a holistic strategy and dedicated leadership to align technology, strategic goals, and people.

This research identifies shared strengths of Scrum and Kanban, such as iterative and incremental work and effective workload management, which are particularly beneficial in startup contexts characterized by high uncertainty. By systematically comparing the fundamental elements of both methodologies, the study delineates key dimensions and components that inform the development of a hybrid approach. This study aimed to explore which components of Kanban and Scrum are best suited for navigating uncertainty and ambiguity in a fast-paced environment. To achieve this objective, our first research question delves into the productive attributes of both Scrum and Kanban methods, laying the groundwork for our investigation. Additionally, we sought to identify the key factors driving adaptations in the application of these methods within software startups, as well as pinpoint the highlighted concepts and elements that can be effectively utilized. This formed the basis of our second research question, with the ultimate aim of developing a hybrid model that integrates the most beneficial aspects of both methodologies, thus addressing the challenges posed by uncertainty and rapid change in the initial phase of the study. We employed a mixed-methods approach, utilizing a literature review, survey, and case study analysis. The theoretical foundation was established through a comprehensive review of existing literature on Scrum and Kanban, supported by the construction of a comparative mind map. Survey data was collected from industry professionals to gather insights into the practical application of these methodologies. Additionally, a case study was conducted to provide a deeper understanding of the challenges and successes in implementing agile practices within a startup environment. Through our research, we identified key dimensions and components of Scrum and Kanban relevant to software startups, including values, principles/practices, team structure, events/cadences, and artifacts. By analyzing survey responses and conducting in-depth interviews, we gained valuable insights into the strengths and limitations of each methodology. Moreover, our case study provided real-world examples of the challenges faced and strategies employed in a startup setting. The findings suggest that while Scrum and Kanban offer distinct strengths, a hybrid approach integrating both methodologies can better address the dynamic needs of software startups. The proposed hybrid model emphasizes flexibility and adaptability, allowing startups to tailor practices to their specific context while leveraging the strengths of Scrum and Kanban. Overall, this research contributes to a deeper understanding of how startups can navigate agile transformation and achieve success in a competitive market.

Hensikt: Hensikten med studien var å få en dypere forståelse av hva operasjonssykepleierne opplever som positivt, og dermed helsefremmende, i arbeidsmiljøet i operasjonsavdelingen, og som bidrar til at de fortsetter å utøve sin profesjon. Metode: En modifisert Grounded theory har blitt benyttet som analysemetode av ti åpne intervjuerResultat: I analysen fremkom kjernekategorien: Samarbeider utfyllende og inkluderende med fokus på pasienten,tre vilkårskategorier: Blir sett og hørt som medarbeider, Har kontinuerlig faglig oppdatering,Har forutsigbarhet i arbeidetog tre konsekvenskategorier: Fyller arbeidstiden og rekker det meste, Opplever at arbeidet er meningsfullt og Opplever samhold og fellesskap med kollegene.Kjernekategorien belyser et samarbeid i operasjonsteamet basert på støtte, gjensidig respekt, tillit, klar kommunikasjon og koordinering samt et tydelig pasientfokus. Vilkår for et slikt samarbeid er mulighet for medvirkning, fokus på operasjonssykepleiefaget og forutsigbarhet gjennom god planlegging og koordinering. Konsekvensene av et godt samarbeid er økt jobbtilfredshet med effektivitet i arbeidet, opplevelse av å gjøre noe av betydning for andre og samhørighet med kolleger. Konklusjon: Et positivt interprofesjonelt samarbeid slik operasjonssykepleierne opplever det, kan bidra til et helsefremmende arbeidsmiljø med positiv effekt på jobbtilfredshet ved god kontroll over kravene i arbeidet, noe som gir økt pasientsikkerhet. Vilkårene for et godt samarbeid som har fremkommet i studien, kan iverksettes i praksis umiddelbart. Det er imidlertid behov for mer forskning på området når det gjelder alle profesjonene i det interprofesjonelle teamet. / Purpose: This qualitative study aimed to gain deeper knowledge of what operating room nurses consider positive in their work environment, thereby promoting employee health and making them stay working in the operating theatre. Method: A modified grounded theory was used to analyze ten open interviews. Result: Analysisof the interviews yielded a core category: inter-professional teamwork that focuses on patient safety. It also identified three subcategories that generate positive teamwork (employee validation, increased opportunities for continuing education, work predictability) and three subcategories that show the consequences of positive teamwork (effective work patterns, experiencing work as meaningful and positive relationships with colleagues). The core category illustrates teamwork that is based on support, mutual respect, trust, clear communication, and coordination. Such teamwork demands the possibility of participating in the decision-making process, focusing on professional work, and making work highly predictable. The consequences of such teamwork include increased jobsatisfaction, an effective and meaningful work experience, and supportive relationships with colleges. Conclusion: From the perspective of operating room nurses interviewed during this study, positive inter-professional teamwork can create a work environment that promotes health, enhances jobsatisfaction, exerts control over work demands,and increases patient safety. The conditions mentioned in this study can be implemented immediately in the workplace. Future research should focus on the different aspects of the inter-professional team / <p>ISBN 987-91-85721-99-3</p>

Background: Psychological perfectionism, from a clinical perspective, started to be a topic of interest for cognitive behavioural clinicians at the beginning of the 1950s. Whilst many studies have identified perfectionism as a pivotal motivator in different conditions of neurosis, the exact nature of its interactions remains unclear. In the research community there is still a debate as to whether there is such a thing as good perfectionism, and there remains no consensual theory of psychopathological perfectionism. Aims: The aim of the study was to investigate why the nature of the phenomena remains a contentious issue, and to develop a robust theory of psychopathological perfectionism, within a cognitive behavioural framework, which will find general acceptance. From the literature review this appears to be the first qualitative study to develop such a theory. Method: Substantive grounded theory was developed within a framework of methodical hermeneutics which, it is argued, is capable of generating formative theory. 20 volunteers who came forward in response to advertisements became participants in semi-structured interviews using a post classic qualitative methodology, from which emerging data became the basis of categories leading to the development of the theory, and functions of the phenomena. Results and Conclusions: The study sets out reasons why there remains an impasse amongst researchers and clinicians about the condition of psychopathological perfectionism. A parsimonious theory of pathological perfectionism has been developed, the constructs of which are just necessary and sufficient to describe the condition. The developed theory makes a contribution to theories proposed prior to 1990 and to contemporary research. However as with all theories it is necessarily provisional, so that its usefulness is in need of further research and development. Psychopathological perfectionism has only two constructs, namely a demand to achieve perfectionism in at least one idiosyncratic sphere, which is in response to a core schema of conditional worth. A number of symptoms or functions of psychopathological perfectionism have also been identified, and there are suggestions as to how the condition develops and is maintained to the detriment of the sufferer. The study synthesizes over fifty years of theory and research into the phenomena. The developed theory and its symptoms or functions have important implications for clinical interventions, training, and for further psychological and psychosocial research. These implications are discussed.

Au-delà des variables climatiques, d’autres facteurs non climatiques sont à considérer dans l’analyse de la vulnérabilité et de l’adaptation au changement et variabilité climatiques. Cette mutation de paradigme place l’agent humain au centre du processus d’adaptation au changement climatique, notamment en ce qui concerne le rôle des réseaux sociaux dans la transmission des nouvelles idées. Dans le domaine de l’agriculture, le recours aux innovations est prôné comme stratégie d’adaptation. L’élaboration et l’appropriation de ces stratégies d’adaptation peuvent être considérées comme des processus d’innovation qui dépendent autant du contexte social et culturel d’un territoire, de sa dynamique, ainsi que de la stratégie elle-même. Aussi, l’appropriation et la diffusion d’une innovation s’opèrent à partir d’un processus décisionnel à l’échelle de l’exploitation agricole, qui à son tour, demande une compréhension des multiples forces et facteurs externes et internes à l’exploitation et les multiples objectifs de l’exploitant. Ainsi, la compréhension de l’environnement décisionnel de l’exploitant agricole à l’échelle de la ferme est vitale, car elle est un préalable incontournable au succès et à la durabilité de toute politique d’adaptation de l’agriculture. Or, dans un secteur comme l’agriculture, il est reconnu que les réseaux sociaux par exemple, jouent un rôle crucial dans l’adaptation notamment, par le truchement de la diffusion des innovations. Aussi, l’objectif de cette recherche est d’analyser comment les exploitants agricoles s’approprient et conçoivent les stratégies d’adaptation au changement et à la variabilité climatiques dans une perspective de diffusion des innovations. Cette étude a été menée en Montérégie-Ouest, région du sud-ouest du Québec, connue pour être l’une des plus importantes régions agricoles du Québec, en raison des facteurs climatiques et édaphiques favorables. Cinquante-deux entrevues ont été conduites auprès de différents intervenants à l’agriculture aux niveaux local et régional. L’approche grounded theory est utilisée pour analyser, et explorer les contours de l’environnement décisionnel des exploitants agricoles relativement à l’utilisation des innovations comme stratégie d’adaptation. Les résultats montrent que les innovations ne sont pas implicitement conçues pour faire face aux changements et à la variabilité climatiques même si l’évolution du climat influence leur émergence, la décision d’innover étant largement déterminée par des considérations économiques. D’autre part, l‘étude montre aussi une faiblesse du capital sociale au sein des exploitants agricoles liée à l’influence prépondérante exercée par le secteur privé, principal fournisseur de matériels et intrants agricoles. L’influence du secteur privé se traduit par la domination des considérations économiques sur les préoccupations écologiques et la tentation du profit à court terme de la part des exploitants agricoles, ce qui pose la problématique de la soutenabilité des interventions en matière d’adaptation de l’agriculture québécoise. L’étude fait ressortir aussi la complémentarité entre les réseaux sociaux informels et les structures formelles de soutien à l’adaptation, de même que la nécessité d’établir des partenariats. De plus, l’étude place l’adaptation de l’agriculture québécoise dans une perspective d’adaptation privée dont la réussite repose sur une « socialisation » des innovations, laquelle devrait conduire à l’émergence de processus institutionnels formels et informels. La mise en place de ce type de partenariat peut grandement contribuer à améliorer le processus d’adaptation à l’échelle locale. / Other than climatic variables, non-climatic factors should be considered in the analysis of vulnerability and adaptation to climate change and variability. This shift in paradigm places the human agent at the centre of the process of adaptation to climate change, particularly with regard to the role of social networks in the transmission of new ideas. In agriculture, the use of innovations is advocated as a coping strategy. The development and adoption of these coping strategies can be considered innovative processes that depend as much on the social and cultural context of a country, its dynamics, and the strategy itself. Also, the ownership and dissemination of an innovation are taking place from a decision-making across the farm, which in turn requires an understanding of the multiple forces and external and internal factors in operation and the multiple objectives of the operator. Thus, understanding of the farmer’s decision- making environment at the farm level is vital because it is a prerequisite for the success and sustainability of any agricultural adaptation policy. However, in a sector like agriculture, it is recognized that social networks for example, play a crucial role in adaptation in particular, through the diffusion of innovations. Therefore, the objective of this research is to analyze how farmers take ownership and design strategies to adapt to climate change and variability from the perspective of diffusion of innovations. This study was conducted in Montérégie- West, a region located in the southwestern part of Quebec and which is known to be one of its most important agricultural regions, due to favorable climatic and soil factors. Fifty-two interviews were conducted with various stakeholders in agriculture at local as well as regional levels. The grounded theory approach is used to analyze and explore the contours of farmers’s decision-making environment regarding the use of innovation as a coping strategy. The results show that innovations are not implicitly designed to cope with climate change and variability even if climate change affects their emergence. The decision to innovate is largely determined by economic considerations. Moreover, the study also shows a weakness of social capital within farmers groups related to the overriding influence of the private sector, which are the main supplier of materials and agricultural inputs. The influence of the private sector has resulted in the dominance of economic considerations over environmental concerns and the temptation of short-term profit from the farmers, which raises the issue of sustainability of interventions in adaptation of Quebec’s agriculture. The study also highlights the complementarity between informal social networks and formal structures of support for adaptation, as well as the need to build partnerships. In addition, the study places the adaptation of Quebec’s agriculture from the perspective of private adaptation whose success is based on a "socialization" of innovations, which should lead to the emergence of formal and informal institutional processes. The establishment of such partnerships can greatly help improve the adaptation process at the local level.

Die qualitative Studie befasst sich mit der Lebenslage von (Ehe-)Paaren, welche in ihrer gemeinsamen Zeit als Zweierbeziehung den Eintritt einer sogenannten „Spätbehinderung“ durch plötzliches Krankheits- oder Unfallgeschehen oder aufgrund einer chronischen Erkrankung erleben. Die inhaltliche Fragestellung richtet sich auf die soziale Handlungspraxis partnerschaftlicher Arbeitsorganisation im Zusammenhang mit dem Eintritt einer körperlichen „Behinderung“ sowie auf die partnerschaftliche Deutung von „Körperbehinderung“ im Rahmen der dyadischen Wirklichkeitskonstruktion. In Erweiterung des aktuellen Forschungsstands wird diesbezüglich nicht allein auf die individuelle Sichtweise des „betroffenen Partners“ oder des „angehörigen Partners“ fokussiert, sondern auch die gemeinsame Ebene dyadischer Wirklichkeitskonstruktion miteinbezogen. Die Datengrundlage dieser Studie im Stil der Grounded Theory Methodologie bilden fünfzehn Interviewreihen, bestehend aus einem Paarinterview (narratives Interview) und anschließenden Einzelinterviews (problemzentriertes Interview) mit jedem Partner. Im Ergebnisteil verdeutlichen sieben Fallbeschreibungen die komplexe paarspezifische Bearbeitung einer „Spätbehinderung“ im Rahmen von Biographie, Ressourcen und Körperlichkeit. Theoretisch verdichtet werden die Ergebnisse in einer Konzeption partnerschaftlicher Konstruktion von Behinderung im Kontext von Leiberfahrung und Körperbetrachtung. Die partnerschaftliche Alltagsverhandlung dreht sich im Zuge der Neukonstruktion von Alltag und „Normalität“ um die körperliche Funktionsfähigkeit des Partners mit Beeinträchtigung und verhandelt dessen Veränderung der Körperlichkeit dabei gleichzeitig mit, wobei körperliche, kulturelle, medizinische und sozialpolitische Aspekte in die partnerschaftliche Deutung mit hinein spielen. Zudem berühren derlei Aushandlungen zentrale Grunddefinitionen von Partnerschaft wie Individualitätsentfaltung, Intimität und Privatheit. / This study focusses on the circumstances of marriage and quasi-marital couples, which experience together diability in later couple lifetime by occurence of chronical illness or impairment of one of the couples members. The contentwise question is on one hand targeted at the social practice of work processes and tasks of couples related to the life change through the occurence of impairment. On the other hand the study demands on the couples interpretation of this experience. The data basis consists of fifteen narrative interview cycles each containing one interview with the couple plus one interview with each marriage partner. Here the situation of a suddenly interruption of everyday life through an event of accident or illness has been contrasted with the situation of chronic ailment with its progressing loss of physical power. The study approach of interviewing, analysing and interpretation founds on the principles of the Grounded Theory Methodology. The results are presented twofold. Firstly seven case reconstructions clarify the couple''s coping with physical body change in the context of biography, capabilities and resources, and physicality and illustrate similarities and differences of the couple’s topics. After this a conception of the couple''s construction of reality in the case of an impairment experience were tendered. It describes the couple’s experience of change, disability and normality as a experience of the physical and functional body, which cannot be extricated from cultural and socio-political framing. Specifically, the main topic of the couple’s negotation concern on the one hand the self-activity of the partner with impairment and on the other hand the availability of the other part and his / her duty to compensate for both the lack of paid work and the increasing amount of time spent for everyday life. Significant is the fact that in this process challenge central positions of the couple’s intimacy and privateness.

<p>The aim of this study has been to investigate, through the narratives of ex-perienced teachers, insights and strategies in the teaching of history in upper secondary school. Based on a flexible grounded theory, life history and theories of pedagogical content knowledge, seven experienced history teachers have been interviewed about their conceptions of history teaching.</p><p>Development of insights into history teaching and the formation of knowledge can be described as involving both a refinement of practice and more revolutionary turning points. These insights emphasize that good knowledge of the subject is central for legitimacy and creativity. History teaching in Sweden is described as increasingly international and contem-porary, and focussed on students’ learning from various points of view. Varied teaching is stressed with the teacher in centre and also being able to take the role of arranger. Of importance is also the handling of teaching in history as a foundation course as well as an advanced or specialized course.</p><p>Influences from other subjects have had a diverse impact at the same time as personal interests and experiences, as well as external influences, have been important for the development of strategies. History teachers’ teaching strategies may be described in terms of 1) multiperspectivity, where different points of view and interpretations of history are central; 2) narrative history, where through both major and minor stories, a chronological structure and animation of the subject of history are strived after; 3) social scientific history, which uses history to explain contemporary society through making comparisons and seeking general patterns; and 4) an eclectic strategy, which strives after varieties of an individualised teaching of history by allowing students to make their ways into history in diverse ways. The experienced history teachers’ narratives make evident how the subject of history can be transformed, they demonstrate different conceivable ways of teaching history and reveal its complexity.</p><p>The teachers’ narratives show how, through their strategies in interaction with their insights in history teaching, they have created an overview and structure in the complex reality of teaching history. The teachers’ insights and strategies constitute a practice based contribution to a more experience informed practice and research on the teaching of history.</p>

Background: The common staff approach in psychiatric care has not been studied explicitly before. Earlier studies in related areas of social processes in psychiatric care highlight the importance of the interaction between the patient and the carer to understanding communication patterns and attitudes. Other studies on social order and power in psychiatric care shows carers and patients as taking part in a hierarchical system in which patients are subordinate to carers. Aim: The overall aim of this thesis is to study the phenomenon of the common staff approach in psychiatric care, how it emerges, and how it is used and experienced by both carers and patients. Method: In the first study, grounded theory was applied to data from observations and interviews carried out with carers and clients in two psychiatric care group dwellings. In the second and third studies, a phenomenological hermeneutic method was used to analyse narrative interviews conducted with nine careers working on psychiatric wards and nine patients with experience of psychiatric in-care, respectively. In the fourth study, qualitative content analysis was used to analyse data obtained by a vignette method from interviews with 13 carers with experience of working in psychiatric in-care. Results: A common staff approach can be understood as a social process in municipality-level group dwellings and psychiatric in-care, imposed by carers on clients or patients with the aim of restoring a predetermined order desired by the carers. When the order is disturbed the carers try to restore it by adopting a common and consistent approach towards the single patient perceived as the threat to order. Barriers to the success of a common staff approach, from the point of view of the carers, include the likelihood that colleagues will interpret situations differently, the chance that patients might succeed in dividing carers into “good” and “bad” camps, and the knowledge that the patient suffers under a common staff approach. The patients’ experiences partly confirm those of the carers – the dominant picture is that the patient feels persecuted and suffers under a common staff approach. However in some situations, patients can perceived the common approach as supportive and aimed to promote their recovery. Carers’ ethical reasoning about the common staff approach is usually applied on an individual basis; it can change depending upon the patient, the situation, and the proposed approach, as well as upon how the approach might affect other patients, staff members, or the carers themselves. Conclusions: The overall results from the four studies show that the common staff approach may meet carers’ needs, which under the approach take precedence over those of patients, but that the approach is more an exercise in asserting power and maintaining control than it is a therapeutic technique; that it is a difficult choice for the single carer to choose between the interests of the patient and the approval of colleagues; that the patient often suffers when a common staff approach is used; and that carers are seldom aware of the suffering experienced by the patient being managed by such an approach. A common staff approach has no part in a care-strategy; it is not an intentional care-plan; instead it appears to be a way for carers who feel vulnerable and under pressure to maintain order by controlling particular patients.